Basic Information
| Provider Information | |||||||||
| NPI: | 1003187535 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHARLES L. HERRING, MD, APC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6221 WILSHIRE BLVD STE 620 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900485215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235560090 | ||||||||
| FaxNumber: | 3235560094 | ||||||||
| Practice Location | |||||||||
| Address1: | 6221 WILSHIRE BLVD STE 620 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900485215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235560090 | ||||||||
| FaxNumber: | 3235560094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2012 | ||||||||
| LastUpdateDate: | 01/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | HERRING | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3235560090 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G84865 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.